An Integrated Approach to HIV Disclosure for HIV-Affected Families in Thailand

Disclosure of HIV status to family members could improve communication, relationship, and cohesion. We evaluated the impact of a family-centered program designed to increase the readiness/willingness of parents to disclose HIV status to their children. People living with HIV (PLWH) with children ≥8 years were surveyed regarding HIV knowledge, family relationship, attitudes, willingness/readiness to disclose, and they were then invited to participate in group education and family camps. Of 367 PLWH surveyed, 0.8% had disclosed, 14.7% had not yet disclosed but were willing/ready to disclose, 50.4% were willing but not ready, and 33.2% did not wish to disclose. The educational sessions and camps led to significant improvements of HIV knowledge and disclosure techniques, and readiness/willingness to disclose. Given the benefits of group education and family camps in supporting PLWH to improve their communication with their families and disclose their HIV status, these supporting activities should be included in HIV programs.

Download Full-text

Disclosure of HIV seropositivity to sexual partner in Ethiopia: A systematic review

Women s Health ◽

10.1177/17455065211063021 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110630

Author(s):

Aklilu Endalamaw ◽

Yibeltal Assefa ◽

Demeke Geremew ◽

Habte Belete ◽

Berihun Assefa Dachew ◽

...

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Sexual Partners ◽

Hiv Positive ◽

People Living With Hiv ◽

Hiv Status ◽

Living With Hiv ◽

Status Disclosure ◽

The Impact

Introduction: In Ethiopia, the burden of HIV/AIDS is a public health issue that requires significant control of transmission. Once an infection has been established, determinants influence people living with HIV to disclose or not their HIV-positive status to sexual partners. This study assessed the proportion and associated factors of people living with HIV’s disclosure status to sexual partners. Methods: CRD42020149092 is the protocol’s registration number in the PROSPERO database. We searched PubMed, Scopus, African Journals Online, and Google Scholar databases. For the subjective and objective assessment of publication bias, we used a funnel plot and Egger’s regression test, respectively. The I2 statistic was used to assess variation across studies. Meta-analysis of weighted inverse variance random-effects model was used to estimate the pooled proportion. We conducted subgroup and sensitivity analyses to investigate the cause of heterogeneity and the impact of outliers on the overall estimation, respectively. A trend analysis was also performed to show the presence of time variation. Results: The percentage of people living with HIV who disclosed their HIV-positive status to sexual partners was 76.03% (95% confidence interval: 68.78, 83.27). Being on antiretroviral therapy (adjusted odds ratio = 6.19; 95% confidence interval: 2.92, 9.49), cohabiting with partner (adjusted odds ratio = 4.48; 95% confidence interval: 1.24, 7.72), receiving HIV counseling (adjusted odds ratio = 3.94; 95% confidence interval: 2.08, 5.80), having discussion prior to HIV testing (adjusted odds ratio = 4.40; 95% confidence interval: 2.11, 6.69), being aware of partner’s HIV status (adjusted odds ratio = 6.08; 95% confidence interval: 3.05, 9.10), positive relationship with partner (adjusted odds ratio = 4.44; 95% confidence interval:1.28, 7.61), and being member of HIV association (adjusted odds ratio = 3.70; 95% confidence interval: 2.20, 5.20) had positive association with HIV status disclosure. Conclusion: In Ethiopia, more than one-fourth of adults living with HIV did not disclose their HIV-positive status to sexual partners. HIV-positive status disclosure was influenced by psychosocial factors. A multidimensional approach is required to increase seropositive disclosure in Ethiopia.

Download Full-text

HIV Disclosure and Quality of Life in People Living with HIV/AIDS in Yogyakarta

Indonesian Journal of Nursing Practices ◽

10.18196/ijnp.v4i2.6989 ◽

2020 ◽

Vol 4 (2) ◽

pp. 50-58

Author(s):

Tutur Irfantoro ◽

Dwi Kartika Rukmi

Keyword(s):

Quality Of Life ◽

Hiv Disclosure ◽

People Living With Hiv ◽

Hiv Status ◽

Cross Sectional ◽

Hiv Status Disclosure ◽

Living With Hiv ◽

Status Disclosure ◽

Hiv Aids

Background: Victory Plus Foundation is a Non-Government Organization that helps the population directly affected by HIV/AIDS in Yogyakarta. Status disclosure’s research on People Living with HIV/AIDS (PLWHA) in Victory Plus Foundation is scarce. Even though the status disclosure is one of HIV spreading prevention, it has two-sided effects, both negative and positive, so its result can affect the quality of life despite PLWHA having tried to find a support system. Therefore, it is essential to know how the quality of life of PLWHA has opened up their status.Purpose: This study aimed to determine the relationship between HIV status disclosure and the quality of life of PLWHA in the Victory Plus Foundation, Yogyakarta.Method: This descriptive-analytic correlation study with a cross-sectional approach was conducted in June-July 2019 on 68 PLWHA at the Victory Plus Foundation. Purposively, samples were asked to fill out a disclosure questionnaire and WHOQOL-BREF. Univariate data presented in descriptions and Chi-Square tested bivariate data.Result: Most of the HIV status disclosure of PLWHA in the Victory Plus foundation was classified into a moderate category (77.9%) and low quality of life (64 %). The bivariate test result found a significant relationship between the HIV status disclosures with the quality of life in general (p = 0.001) with a moderate relationship closeness (r=0.403).Conclusion: Consequently, there is a relationship between the HIV status disclosures with the quality of life of PLWHA in the Victory Plus Foundation in Yogyakarta.

Download Full-text

Substance Use and Motivational Interviewing

Motivational Interviewing in HIV Care ◽

10.1093/med/9780190619954.003.0011 ◽

2019 ◽

pp. 105-114 ◽

Cited By ~ 1

Author(s):

Liu yi Lin ◽

Linda R. Frank ◽

Antoine Douaihy

Keyword(s):

Substance Use ◽

Motivational Interviewing ◽

Substance Use Disorder ◽

Integrated Approach ◽

Hiv Care ◽

People Living With Hiv ◽

Co Morbidity ◽

Important Health ◽

Living With Hiv ◽

The Impact

People living with HIV (PLWH) who use drugs and alcohol are particularly likely to experience gaps across the HIV care continuum. People with co-occurring HIV and a substance use disorder face significant challenges in treatment. Substance use is well-known to be linked to important health behaviors and outcomes including adherence to antiretroviral and treatment, immunosuppression, and sexual risk behaviors. This chapter provides a review of the impact of substance use in PLWH and the role of motivational interviewing as part of an integrated approach to care of PLWH with co-occurring substance use disorders. The chapter concludes with a case example to illustrate the role that motivational interviewing can play the care of PLWH with a co-morbidity of substance use disorder.

Download Full-text

National HIV testing and diagnosis coverage in sub-Saharan Africa: a new modeling tool for estimating the “first 90” from program and survey data

10.1101/532010 ◽

2019 ◽

Author(s):

M Maheu-Giroux ◽

K Marsh ◽

C Doyle ◽

A Godin ◽

C Lanièce Delaunay ◽

...

Keyword(s):

Hiv Testing ◽

Critical Role ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

Hiv Status ◽

Hiv Diagnosis ◽

Hiv Knowledge ◽

Out Of Sample ◽

Living With Hiv ◽

Program Data

AbstractObjectiveHIV testing services (HTS) are a crucial component of national HIV responses. Learning one’s HIV diagnosis is the entry point to accessing life-saving antiretroviral treatment and care. Recognizing the critical role of HTS, theJoint United Nations Programme on HIV/AIDS(UNAIDS) launched the 90-90-90 targets stipulating that by 2020, 90% of people living with HIV know their status, 90% of those who know their status receive antiretroviral therapy, and 90% of those on treatment have a suppressed viral load. Countries will need to regularly monitor progress on these three indicators. Estimating the proportion of people living with HIV who know their status (i.e., the “first 90”), however, is difficult.MethodsWe developed a mathematical model (henceforth referred to as “F90”) that formally synthesizes population-based survey and HTS program data to estimate HIV status awareness over time. The proposed model uses country-specific HIV epidemic parameters from the standard UNAIDS Spectrum model to produce outputs that are consistent with other national HIV estimates. The F90 model provides estimates of HIV testing history, diagnosis rates, and knowledge of HIV status by age and sex. We validate the F90 model using both in-sample comparisons and out-of-sample predictions using data from three countries: Côte d’Ivoire, Malawi, and Mozambique.ResultsIn-sample comparisons suggest that the F90 model can accurately reproduce longitudinal sex-specific trends in HIV testing. Out-of-sample predictions of the fraction of PLHIV ever tested over a 4-to-6-year time horizon are also in good agreement with empirical survey estimates. Importantly, out-of-sample predictions of HIV knowledge are consistent (i.e., within 4% points) with those of the fully calibrated model in the three countries, when HTS program data are included. The F90 model’s predictions of knowledge of status are higher than available self-reported HIV awareness estimates, however, suggesting –in line with previous studies– that these self-reports are affected by non-disclosure of HIV status awareness.ConclusionKnowledge of HIV status is a key indicator to monitor progress, identify bottlenecks, and target HIV responses. The F90 model can help countries track progress towards their “first 90” by leveraging surveys of HIV testing behaviors and annual HTS program data.

Download Full-text

Differences in Post-mRNA Vaccination SARS-CoV-2 IgG Concentrations and Surrogate Virus Neutralization Test Response by HIV Status and Type of Vaccine: a Matched Case-Control Observational Study

Clinical Infectious Diseases ◽

10.1093/cid/ciab1009 ◽

2021 ◽

Author(s):

Matthew A Spinelli ◽

Michael J Peluso ◽

Kara L Lynch ◽

Cassandra Yun ◽

David V Glidden ◽

...

Keyword(s):

Neutralization Test ◽

Virus Neutralization Test ◽

Virus Neutralization ◽

People Living With Hiv ◽

Hiv Status ◽

Test Response ◽

Cell Counts ◽

Matched Case ◽

Living With Hiv ◽

The Impact

Abstract Following SARS-CoV-2 mRNA vaccination, people living with HIV (PLWH) had lower surrogate virus neutralization test response (p=0.03) and a trend towards lower IgG response (p=0.08), particularly among those with lower CD4+T-cell counts and who received the BNT162b2 vaccine. Study of the impact of supplemental vaccine doses among PLWH is needed.

Download Full-text

Undetectable equals untransmittable (U = U): awareness and associations with health outcomes among people living with HIV in 25 countries

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054551 ◽

2020 ◽

pp. sextrans-2020-054551 ◽

Cited By ~ 6

Author(s):

Chinyere Okoli ◽

Nicolas Van de Velde ◽

Bruce Richman ◽

Brent Allan ◽

Erika Castellanos ◽

...

Keyword(s):

Health Outcomes ◽

Standard Of Care ◽

Hiv Care ◽

People Living With Hiv ◽

Hiv Status ◽

Missed Opportunities ◽

Suboptimal Adherence ◽

Health Related ◽

Living With Hiv ◽

The Impact

Objectives‘Undetectable equals Untransmittable’ (U=U) is an empowering message that may enable people living with HIV (PLHIV) to reach and maintain undetectability. We estimated the percentage of PLHIV who ever discussed U=U with their main HIV care provider, and measured associations with health-related outcomes. Secondarily, we evaluated whether the impact of the U=U message varied between those who heard it from their healthcare provider (HCP) vs from elsewhere.MethodsData were from the 25-country 2019 Positive Perspectives Survey of PLHIV on treatment (n=2389). PLHIV were classified as having discussed U=U with their HCP if they indicated that their HCP had ever told them about U=U. Those who had not discussed U=U with their HCP but were nonetheless aware that ‘My HIV medication prevents me from passing on HIV to others’ were classified as being made aware of U=U from non-HCP sources. Multivariable logistic regression was used to measure associations between exposure to U=U messages and health outcomes.ResultsOverall, 66.5% reported ever discussing U=U with their HCP, from 38.0% (South Korea) to 87.3% (Switzerland). Prevalence was lowest among heterosexual men (57.6%) and PLHIV in Asia (51.3%). Compared with those unaware of U=U, those reporting U=U discussions with their HCP had lower odds of suboptimal adherence (AOR=0.59, 95% CI 0.44 to 0.78) and higher odds of self-reported viral suppression (AOR=2.34, 95% CI 1.72 to 3.20), optimal sexual health (AOR=1.48, 95% CI 1.14 to 1.92) and reporting they ‘always shared’ their HIV status (AOR=2.99, 95% CI 1.42 to 6.28). While exposure to U=U information from non-HCP sources was beneficial too, the observed associations were attenuated relative to those seen with reported discussions with HCPs.ConclusionHCP discussion of U=U with PLHIV was associated with favourable health outcomes. However, missed opportunities exist since a third of PLHIV reported not having any U=U discussion with their HCP. U=U discussions with PLHIV should be considered as a standard of care in clinical guidelines.

Download Full-text

The impact of living with HIV: differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia

Sexual Health ◽

10.1071/sh12170 ◽

2013 ◽

Vol 10 (4) ◽

pp. 316 ◽

Cited By ~ 12

Author(s):

Loren Brener ◽

Hannah Wilson ◽

Sean Slavin ◽

John de Wit

Keyword(s):

Hiv Treatment ◽

Hiv Stigma ◽

Heterosexual Transmission ◽

People Living With Hiv ◽

Hiv Status ◽

Health And Wellbeing ◽

Gay Community ◽

Related Stigma ◽

Living With Hiv ◽

The Impact

Background HIV in Australia has been closely aligned with the gay community and continues to disproportionately affect members of this community. Although heterosexual transmission remains low, recently there has been an increase in new HIV diagnoses attributable to heterosexual sex. This highlights the need to address the health and social consequences for heterosexual people living with HIV (PLHIV). This subanalysis of a larger study compared the experiences of stigma, health and wellbeing of a sample of gay and heterosexual PLHIV. Methods: Data were drawn from a study of experiences of stigma among PLHIV in Australia. All 49 participants who reported being heterosexual were included, as were 49 participants randomly selected from the 611 gay participants. The samples were compared on perceived HIV stigma, HIV treatment-related stigma, perceived negative reactions of others, HIV status disclosure, and health and wellbeing measures. Results: The findings illustrate that heterosexual PLHIV have more negative experiences in terms of both general HIV stigma and treatment-related stigma than gay PLHIV. The heterosexual PLHIV also perceived greater negative reactions in relation to their HIV status by different people in their social environment and were less likely to access treatment than the gay PLHIV. There were no differences between the two groups in any of the health and wellbeing measures. Conclusions: This study shows that in the Australian context, heterosexual PLHIV may feel more stigmatised than gay PLHIV. In view of lower HIV treatment uptake in heterosexual PLHIV, addressing HIV-related stigma could contribute to increasing access to HIV treatment.

Download Full-text

A QUESTION MODULE FOR ASSESSING COMMUNITY STIGMA TOWARDS HIV IN RURAL INDIA

Journal of Biosocial Science ◽

10.1017/s0021932012000697 ◽

2012 ◽

Vol 45 (3) ◽

pp. 359-374 ◽

Cited By ~ 3

Author(s):

CAROL VLASSOFF ◽

MITCHELL G. WEISS ◽

SHOBHA RAO

Keyword(s):

Disease Transmission ◽

Married Women ◽

Rural India ◽

People Living With Hiv ◽

Hiv Knowledge ◽

Related Stigma ◽

Simple Question ◽

Stigmatizing Attitudes ◽

Living With Hiv ◽

The Impact

SummaryThis paper describes a simple question module to assess community stigma in rural India. Fear of stigma is known to prevent people from seeking HIV testing and to contribute to further disease transmission, yet relatively little attention has been paid to community stigma and ways of measuring it. The module, based on a vignette of a fictional HIV-positive woman, was administered to 494 married women and 186 unmarried male and female adolescents in a village in rural Maharashtra, India. To consider the usefulness of the question module, a series of hypotheses were developed based on the correlations found in other studies between HIV-related stigma and socio-demographic characteristics (age, education, discussion of HIV with others, knowing someone living with HIV, knowledge about its transmission and whether respondents acknowledged stigmatizing attitudes as their own or attributed them to others). Many of the study's hypotheses were confirmed. Among married women, correlates of stigma included older age, lack of discussion of HIV and lack of knowledge about transmission; among adolescents, lower education and lack of discussion of HIV were the most significant correlates. The paper concludes that the question module is a useful tool for investigating the impact of interventions to reduce stigma and augment social support for people living with HIV in rural India.

Download Full-text

Views on HIV Disclosure Among Older Adults Living With HIV Who Are Childhood Sexual Abuse Survivors

Innovation in Aging ◽

10.1093/geroni/igaa057.1088 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 339-339

Author(s):

Monique Brown ◽

Titilayo James ◽

Chigozie Nkwonta ◽

Amandeep Kaur

Keyword(s):

Older Adults ◽

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Casual Sex ◽

Hiv Disclosure ◽

People Living With Hiv ◽

Hiv Status ◽

Structured Interviews ◽

Related Stigma ◽

Living With Hiv

Abstract Rates of childhood sexual abuse (CSA) among people living with HIV are twice the CSA estimates among the general population. These statistics suggest that CSA prevalence may range from 16-22% among older adults living HIV (OALH). HIV disclosure continues to be a key consideration among people living with HIV. However, studies examining the views on HIV disclosure among OALH who are CSA survivors are lacking. Therefore, the aim of this study was to explore the views on HIV disclosure among OALH who are CSA survivors using a qualitative approach. Twenty-four adults aged 50-67 years, living with HIV and with a CSA history participated in the study. In-depth semi-structured interviews were conducted, audio-recorded and were analyzed using thematic analysis. The iterative analytic process included discussion of initial thoughts and key concepts, identification and reconciliation of codes, and naming of emergent themes. Three themes emerged: “You don’t have to tell the person if it’s just casual sex”, “Nothing ought to be hidden especially when you get ready to engage in sex”, and “As for me, I don’t disclose”. Views on HIV disclosure among OALH varied. Some participants stated that disclosure of HIV status should be dependent on the type of sexual relationship, while some OALH stated that participants should disclose regardless of type of relationship. Some participants were hesitant to disclose their HIV status due to anticipated HIV-related stigma. Understanding the perspectives on HIV disclosure among OALH with a CSA history may help to inform disclosure intervention programs for this vulnerable population.

Download Full-text

The Lived Experiences of Stigmatization in the Process of HIV Status Disclosure among People Living with HIV in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105089 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5089

Author(s):

Chia-Hui Yu ◽

Chu-Yu Huang ◽

Nai-Ying Ko ◽

Heng-Hsin Tung ◽

Hui-Man Huang ◽

...

Keyword(s):

Lived Experiences ◽

Healthcare Professionals ◽

Social Stigma ◽

People Living With Hiv ◽

Hiv Status ◽

Structured Interviews ◽

Two Phases ◽

Hiv Status Disclosure ◽

Living With Hiv ◽

Status Disclosure

People living with HIV (PLWH) face social stigma which makes disclosure of HIV status difficult. The purpose of this descriptive qualitative study was to understand the lived experiences of stigmatization in the process of disease disclosure among PLWH in Taiwan. Analysis of the semi-structured interviews from 19 PLWH in Taiwan revealed two phases and six themes. Phase one “experiences before disclosure” involved three themes: “Struggles under the pressure of concealing the HIV Status,” “Torn between fear of unemployment/isolation and desire to protect closed ones,” and “Being forced to disclose the HIV status.” Phase two “experiences after disclosure” included three themes: “Receiving special considerations and requirements from school or work,” “Receiving differential treatments in life and when seeking medical care,” and “Stress relief and restart.” Healthcare professionals need to assess stigmatization in PLWH and develop individualized approaches to assist with the disease disclosure process.

Download Full-text